Difference between revisions of "Knee arthroplasty"
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{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = | | anesthesia_type = General or spinal | ||
| airway = | Regional | ||
| lines_access = | | airway = ETT/LMA if general | ||
| monitors = | | lines_access = PIV | ||
| monitors = Standard | |||
5-lead ECG | |||
| considerations_preoperative = | | considerations_preoperative = | ||
| considerations_intraoperative = | | considerations_intraoperative = | ||
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}} | }} | ||
'''Knee arthroplasty''' is a surgical procedure to resurface a knee damaged by arthritis. | |||
== Overview == | |||
=== Indications === | |||
* Knee arthritis (inflammatory) or arthrosis (non-inflammatory degeneration) | |||
* Infected knee | |||
* Loose or malpositioned knee prothesis | |||
=== Surgical procedure === | |||
* | |||
== Preoperative management == | == Preoperative management == | ||
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|- | |- | ||
|Neurologic | |Neurologic | ||
| | |Arthritis may impair neck ROM or cause cervical nerve root compression. | ||
|- | |- | ||
|Cardiovascular | |Cardiovascular | ||
| | |Patients with arthritis may have limited exercise tolerance due to knee pain, thus impairing assessment of cardiovascular function. Stress echo may be needed for cardiac evaluation. | ||
|- | |- | ||
|Pulmonary | |Pulmonary | ||
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|- | |- | ||
|Other | |Other | ||
| | |Patients may have rheumatoid arthritis | ||
|} | |} | ||
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=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | ||
* Adductor canal block | |||
* Femoral nerve block +/- lateral femoral cutaneous | |||
* Sciatic nerve block | |||
Note: Some surgeons will perform a periarticular injection with a long-lasting local anesthetic (i.e. liposomal bupivicaine) prior to emergence. | |||
== Intraoperative management == | == Intraoperative management == | ||
=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | === Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> === | ||
* Standard ASA monitors | |||
* PIV | |||
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | ||
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[[Category:Surgical procedures]] | [[Category:Surgical procedures]] | ||
Latest revision as of 23:45, 4 April 2022
Knee arthroplasty
| Anesthesia type |
General or spinal Regional |
|---|---|
| Airway |
ETT/LMA if general |
| Lines and access |
PIV |
| Monitors |
Standard 5-lead ECG |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Knee arthroplasty is a surgical procedure to resurface a knee damaged by arthritis.
Overview
Indications
- Knee arthritis (inflammatory) or arthrosis (non-inflammatory degeneration)
- Infected knee
- Loose or malpositioned knee prothesis
Surgical procedure
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | Arthritis may impair neck ROM or cause cervical nerve root compression. |
| Cardiovascular | Patients with arthritis may have limited exercise tolerance due to knee pain, thus impairing assessment of cardiovascular function. Stress echo may be needed for cardiac evaluation. |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other | Patients may have rheumatoid arthritis |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
- Adductor canal block
- Femoral nerve block +/- lateral femoral cutaneous
- Sciatic nerve block
Note: Some surgeons will perform a periarticular injection with a long-lasting local anesthetic (i.e. liposomal bupivicaine) prior to emergence.
Intraoperative management
Monitoring and access
- Standard ASA monitors
- PIV
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Barrett Larson, Chris Rishel and Tony Wang